19D2079151 CLIA NUMBER - BATON ROUGE CLINIC OLIVER WOUND CARE

Laboratory Demographics

  • CLIA Code: 19D2079151
  • Facility Name: BATON ROUGE CLINIC OLIVER WOUND CARE
  • Facility Address: 920 OLIVER RD, WAITING AREA A2
    MONROE, LA
    ZIP 71201
  • Facility Phone: 318 807-1500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WHITNEY DELASALLE
  • NPI Number: 1053722066
  • Taxonomy: 235Z00000X - Speech-Language Pathologist

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CLIA Record

Field Name Field Value
CLIA Number 19D2079151
LAB Type Physician Office
Facility Name BATON ROUGE CLINIC OLIVER WOUND CARE
Street 920 OLIVER RD, WAITING AREA A2
City MONROE
State LA
ZIP 71201
Phone 318 807-1500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2024
Certificate Expiration Date 6/10/2026
Facility Type Physician Office
Lab Director WHITNEY DELASALLE

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This page was last updated on: 9/29/2025